Burn nursing specialty
Trauma and Burn NCLEX Questions
Question A community health nurse is planning a health education session on burn prevention for families in a residential area. Which of the following topics should the nurse prioritize to effectively reduce the risk of burns in the home environment?
A. The importance of regular exercise and a balanced diet
B. Safe storage of flammable materials
C. Techniques for safe outdoor grilling
D. The benefits of installing smoke detectors in every bedroom
E. Proper handwashing techniques
Correct Answer: B. Safe storage of flammable materials
Rationale: The safe storage of flammable materials is crucial in preventing fires and subsequent burns within the home. Materials such as gasoline, alcohol, and cooking oils, when improperly stored, pose a significant risk for igniting fires. Educating families on the importance of storing these materials in cool, dry places away from heat sources can significantly reduce the likelihood of accidental fires. This intervention directly targets a common cause of household fires, making it a priority in burn prevention education.
Question In a pediatric clinic, the nurse is advising parents on preventing scald burns in children. Which of the following recommendations is the most effective in preventing these types of burns?
A. Encouraging children to play away from the kitchen
B. Installing safety gates at the kitchen entrance
C. Testing the bath water temperature before bathing a child
D. Keeping hot drinks out of children’s reach
E. Teaching children the “stop, drop, and roll” technique
Correct Answer: C. Testing the bath water temperature before bathing a child
Rationale: Scald burns in children often occur from hot liquids or steam, with bath water being a common cause. Testing the water temperature before placing a child in the bath ensures it is not too hot, preventing accidental scald burns. This practice provides a direct method to control the environment the child is exposed to, reducing the risk of burns from a common household activity. It is an immediate and practical measure that parents can easily implement to protect their children from this type of injury.
Question A nurse is conducting a community education session on fire safety. Which of the following statements should the nurse include when teaching about the prevention of electrical burns?
A. “Wear synthetic clothing while cooking to prevent burns.”
B. “Use extension cords as a permanent wiring solution.”
C. “Ensure electrical appliances are grounded before use.”
D. “Keep all electrical appliances in the bathroom for convenience.”
E. “Cover outlets with tape instead of safety plugs.”
Correct Answer: C. “Ensure electrical appliances are grounded before use.”
Rationale: Electrical burns can occur when there is an improper use of electrical appliances, including the failure to ensure they are grounded. Grounding electrical appliances helps to prevent electrical current from taking an unintended path to ground, which can result in burns or electrical shock. This safety measure protects against electrical hazards by providing a safe path for the electrical current, reducing the risk of burns. Educating the community on this practice addresses a common risk factor for electrical burns and promotes a safer environment.
Question While planning a summer safety campaign, a public health nurse decides to focus on prevention strategies for sunburns. Which of the following strategies should be emphasized as the most effective for preventing sunburn?
A. Applying a sunscreen with a minimum SPF of 30
B. Wearing lightweight, cotton clothing
C. Staying indoors between 10 a.m. and 2 p.m.
D. Consuming foods high in antioxidants
E. Using tanning beds instead of natural sunlight
Correct Answer: A. Applying a sunscreen with a minimum SPF of 30
Rationale: Sunscreen acts as a protective barrier against the sun’s harmful ultraviolet (UV) rays, which are the primary cause of sunburns. An SPF of 30 or higher blocks out a significant portion of these rays, reducing the risk of skin damage and subsequent burns. This strategy is effective because it directly addresses the exposure to UV rays, providing a measurable level of protection. Encouraging the regular application of sunscreen, especially when spending extended periods outdoors, is a key preventive measure against sunburn.
Question A nurse is educating a group of adolescents on firework safety to prevent burn injuries during national holidays. Which of the following tips should the nurse include as a key safety measure?
A. Lighting fireworks in a metal container
B. Keeping a bucket of water or a hose nearby when using fireworks
C. Running away quickly after lighting fireworks
D. Using matches instead of a lighter to ignite fireworks
E. Holding fireworks in hand to ensure they launch properly
Correct Answer: B. Keeping a bucket of water or a hose nearby when using fireworks
Rationale: The presence of a water source such as a bucket of water or a hose is crucial when using fireworks, as it provides a means to quickly extinguish any unintended fires or to cool any burns that might occur accidentally. This safety measure directly addresses the immediate risks associated with the use of fireworks, offering a practical solution to prevent and mitigate burn injuries. It encourages preparedness and quick response in case of fire-related emergencies, making it an essential tip for safe firework usage.
Question When educating elderly clients about preventing burns in the home, which of the following recommendations should a nurse prioritize to address the most common risk factor for burns in this population?
A. Avoiding the use of space heaters in close proximity to furniture
B. Wearing non-slip shoes indoors
C. Lowering the setting on the water heater to prevent scalds
D. Using night lights in hallways and bathrooms
E. Installing handrails in the bathroom
Correct Answer: C. Lowering the setting on the water heater to prevent scalds
Rationale: Elderly individuals are at a higher risk for scald burns due to decreased skin thickness and a diminished ability to perceive extreme temperatures quickly. Lowering the water heater setting to a safe temperature (around 120°F or lower) can prevent scald burns by ensuring that tap water is not hot enough to cause burns on contact. This preventive measure directly addresses a common cause of burns in the elderly, providing a simple yet effective way to reduce the risk of scalding. Educating on this aspect can significantly impact safety in the home environment for the elderly.
Question A school nurse is preparing a lesson on burn prevention for elementary school students. Which of the following activities should the nurse emphasize as requiring adult supervision to prevent burns?
A. Drawing with crayons
B. Playing with battery-operated toys
C. Cooking or baking in the kitchen
D. Reading books
E. Using water-based paints
Correct Answer: C. Cooking or baking in the kitchen
Rationale: Cooking or baking involves the use of hot surfaces, appliances, and potentially hot liquids or foods, all of which pose a significant burn risk to children. By emphasizing the need for adult supervision during these activities, the nurse addresses a common and preventable scenario in which children can sustain burns. This advice encourages the development of safe practices around activities that are part of daily life but can be hazardous without proper precautions. Teaching children to seek adult assistance with cooking or baking can greatly reduce the incidence of burns in this age group.
Question For a family living in a rural area with limited access to emergency medical services, which of the following fire safety measures should a community health nurse emphasize as crucial for preventing burns and ensuring safety?
A. Maintaining a clear zone free of vegetation around the home
B. Storing large quantities of water for firefighting purposes
C. Learning basic firefighting techniques
D. Establishing a community watch program
E. Regular inspection and cleaning of chimney flues
Correct Answer: E. Regular inspection and cleaning of chimney flues
Rationale: In rural areas, the use of wood-burning stoves or fireplaces for heating and cooking is common, making the risk of chimney fires a significant concern. Regular inspection and cleaning of chimney flues can prevent the buildup of creosote, a flammable by-product of wood combustion that can ignite and cause a chimney fire. This preventive measure directly addresses a specific risk factor pertinent to the living conditions in rural areas, offering a practical approach to reducing the risk of fires and associated burns. Educating families on the importance of chimney maintenance promotes a safer living environment by mitigating a common source of fires.
Question A nurse is discussing outdoor burn prevention with a group of teenagers planning a camping trip. Which of the following recommendations is the most important for preventing burns from campfires?
A. Choosing synthetic clothing for better insulation
B. Setting up tents at least 10 feet away from the campfire
C. Using a flashlight instead of a campfire for light at night
D. Keeping flammable liquids away from the campfire
E. Eating cold food to avoid the need for cooking over a fire
Correct Answer: D. Keeping flammable liquids away from the campfire
Rationale: Flammable liquids, such as gasoline or alcohol, can dramatically increase the risk of a fire spreading uncontrollably or causing explosive burns if they come into contact with a campfire. This recommendation directly addresses the prevention of one of the most hazardous and preventable causes of burns in a camping environment. Educating teenagers on the importance of maintaining a safe distance between flammable substances and open flames can significantly reduce the risk of accidental burns. It fosters awareness of fire safety practices that are critical in outdoor settings, where medical help may not be immediately accessible.
Question In an urban community center, a nurse is leading a workshop on first aid for burns. Which of the following pieces of advice should the nurse emphasize as the first step in treating a minor thermal burn?
A. Applying butter to the burn area
B. Covering the burn with a dry cloth
C. Cooling the burn under running tap water
D. Bursting any blisters that form
E. Applying a thick layer of aloe vera gel immediately
Correct Answer: C. Cooling the burn under running tap water
Rationale: Cooling a minor thermal burn under running tap water helps to reduce the heat, limit the depth of the burn, and alleviate pain. This method is recommended as the first step in first aid for minor burns because it addresses the immediate need to stop the burning process and cool the skin. By doing so, it helps to prevent further tissue damage and promotes pain relief. Emphasizing this as a primary response educates the community on an effective and accessible initial treatment for thermal burns, enhancing overall safety and preparedness.
Burn nursing is a nursing specialty that focuses on providing specialized care to patients with burn injuries. Read more below…
Burn nurses are trained professionals who possess expertise in caring for patients with burns and play a critical role in managing burn injuries. The American Burn Association is an organization that promotes and supports burn nursing and provides resources and education to burn nurses across the United States. Burn injuries often require specialized care to manage pain, prevent infection, and promote healing.
Burn nurses
Burn nurses work closely with patients to ensure that their physical, emotional, and psychological needs are met, and they are trained to use various techniques to manage pain and promote healing. Through their expertise and dedication, burn nurses play an essential role in improving outcomes for patients with burn injuries. The field of burn nursing specialty is an important and specialized area of nursing practice that focuses on providing specialized care to patients with burn injuries. Burn nurses are highly trained professionals who possess expertise in caring for patients with burns, and they play a critical role in the management of burn injuries. One way for nurses to demonstrate their advanced knowledge and expertise in this area of nursing specialty is by becoming a Certified Burn Registered Nurse (CBRN).
CBRN certification
The CBRN certification is a nursing specialty certification that recognizes the advanced knowledge and expertise of registered nurses in. To obtain this certification, nurses must meet specific eligibility requirements, including having a current RN license, a minimum of two years of experience in burn nursing, and at least 2,000 hours of clinical practice in burn care within the past five years. The certification process includes a detailed exam content outline covering advanced burn nursing knowledge topics, wound care, prehospital and acute care, trauma nursing, critical care ground transport, and pediatric emergency care. The CBRN certification is an essential credential that demonstrates the nurse’s dedication to the field of burn and emergency nursing, their commitment to ensuring optimal patient safety and quality nursing care. Additionally, this certification allows nurses to enhance their career opportunities and to earn potential while advancing their knowledge and skills in burn and emergency nursing
The burn nursing specialty body includes a community of burn care nurses who share a common goal of encouraging quality nursing care for patients with burn injuries. The American Nurses Association (ANA) supports this community by providing resources and education on burn nursing practice and by promoting the importance of a burn nursing specialty certification, for nurses. The ANA recognizes that burn injuries are complex and require specialized care to manage pain, prevent infection, and promote healing. Burn nurses work closely with patients to ensure that their physical, emotional, and psychological needs are met, and they are trained to use a variety to manage pain and promote healing. Through their expertise and dedication, burn nurses play an essential role in improving outcomes for patients with burn injuries. The burn nursing specialty certification and credential is valuable for nurses who want to demonstrate their advanced knowledge and expertise in this area. The burn nursing specialty certification and process includes a detailed exam content outline that covers a broad range of topics related to burn nursing practice. The exam is developed by a team of nursing subject matter experts who ensure that the content is relevant and up-to-date with current nursing practice standards.
The burn nursing community is comprised of nurses who share a passion for caring for patients with burn injuries. This community includes burn care nurses, research nurse supervisors board certified, burn nursing specialty credential, nurses, and other healthcare professionals who work together to advance the field of burn nursing through research, education, and collaboration. One of the essential aspects of burn nursing practice is burn wound care. Burn wounds require specialized care to promote healing and prevent infection. Burn nurses are trained to assess and manage burn wounds using various techniques, including dressings, topical agents, and debridement. Prehospital and acute care are also critical components of burn nursing practice. Burn nurses must be prepared to provide care in various settings, including emergency departments, burn units, and critical care units. They must also work closely with other healthcare professionals, including physicians, physical therapists, and social workers, to ensure that patients receive comprehensive care. Pediatric emergency care is another essential burn nursing and trauma nursing practice component. Burn injuries can be particularly challenging for children, and burn nurses must be trained to assess and manage these injuries in a way that is appropriate for the child’s age and developmental level. They must also be prepared to provide emotional support to children and their families, who may be experiencing significant stress and anxiety.
Burn nursing
The core curriculum for burn nursing includes a broad range of topics related to caring for patients with burn injuries. This curriculum consists of both core burn nurse knowledge and advanced burn nurse knowledge. It is designed to provide nurses with a comprehensive understanding of the complex issues related to burns care to develop board certified burn nurses.
Working closely with burn nurses
The role of an infection control nurse is crucial in the prevention and control of infections in healthcare settings. Infection control nurses play a vital role in identifying, preventing, and managing the spread of infectious diseases among patients and healthcare workers. The importance of an infection control nurses in healthcare and their daily activities in providing burn patient care is vital. They may also work with the research nurse supervisor to develop epidemiological data for the burn unit.
Infection refers to the invasion and multiplication of microorganisms such as bacteria, viruses, and fungi in the human body. Infections can lead to diseases that can range from mild to severe or life-threatening. Infectious diseases can be transmitted through various means, such as contact with bodily fluids, contaminated surfaces, or through the air.
To become an infection control nurse, one must obtain an infectious disease nurse certification. This is specialty certification that is granted to nurses who have specialized knowledge and skills in preventing and controlling the spread of infectious diseases. Nurses with this specialty certification play a vital role in preventing infections in various settings, such as hospitals, clinics, and long-term care facilities. Infection control nurses play a crucial role in preventing and controlling infections in patients who are at high risk, such as burn and trauma patients. These patients have compromised immune systems, making them more susceptible to infections. Infection control nurses work closely with these patients to prevent infections by implementing preventive measures such as isolation precautions, hand hygiene, and proper use of personal protective equipment (PPE). Infection control nurses also play a crucial role in preventing infections in hospitalized patients. They monitor the environment, including the cleanliness of the facility, and provide education to healthcare workers and patients on infection control measures. Infection control nurses also collaborate with healthcare providers to ensure that patients receive appropriate treatment for their infections.
In addition to hospitalized patients, infection control nurses also provide care to outpatients. They implement preventive measures such as triage and screening to identify patients with infectious diseases and prevent the spread of infections in the community. They and registered nurses also provide education to patients on the importance of infection control measures, such as hand hygiene and cough etiquette. The infectious disease nurse job description includes a variety of tasks related to preventing and controlling infections in healthcare settings. One of their primary responsibilities is to monitor the spread of infectious diseases and implement preventive measures to stop the spread. They also educate healthcare workers and patients on the importance of infection control measures and provide guidance on proper hand hygiene, the use of PPE, and isolation precautions. Infection control nurses also work closely with the healthcare team to implement infection control policies and procedures. They ensure that healthcare workers adhere to these policies and procedures to prevent the spread of infections. Infection control nurses monitor and report infections to the appropriate authorities and implement corrective measures to prevent future infections. Infection control nurses are responsible for developing and implementing infection control training programs for healthcare workers. These training programs provide education on infection control measures, including hand hygiene, the use of PPE, and isolation precautions. They also provide education on the identification and management of infectious diseases, including the appropriate use of antibiotics.
Infection control nurses also work with nursing subject matter experts to develop and implement infection control guidelines and policies. They ensure that these guidelines and policies are evidence-based and meet the standards set by regulatory agencies such as the American Nurses Association and the Centers for Disease Control and Prevention. The daily activities of an infection control nurse include patient care, surveillance, and education. Patient care involves implementing infection control measures for patients who are at high risk of infection. Surveillance involves monitoring patients and the environment for infections and implementing preventive measures to stop the spread. Education involves providing education to healthcare workers and patients on infection control measures and the importance of preventing the spread of infections.
The role of an infection control nurse is critical in ensuring the prevention and control of infections in healthcare settings. Infection control nurses play a crucial role in identifying, preventing, and managing the spread of infectious diseases among patients and healthcare workers. They work closely with healthcare providers to ensure that patients receive appropriate treatment for their infections, and they implement preventive measures to prevent future infections. The infectious disease nurse job description includes a variety of tasks related to preventing and controlling infections in healthcare settings, and their daily activities involve patient care, surveillance, and education. By encouraging quality nursing care and ensuring optimal patient safety, infection control nurses play an essential role in maintaining the health and well-being of patients.
Introduction to burn infections for nursing students and NCLEX
Risk factors for infections in trauma and burn victims
• More common with burns of >30% TBSA
• More common in patients with burns not excised
• May be responsible for conversion of partial thickness burns to full thickness burns
• Suspect if you see black or hemorrhagic focal areas
Bacteria
Initially (early post-burn) – predominately gram positive (GP) organisms
Post burn day 5 – some gram negative (GN) organisms
Post burn day 10 – GN organisms predominate
What is the difference between burn wound colonization and burn wound infection?
COLONIZATION – The organisms in the wound are not in the unburned tissue
INFECTION – Organisms have ‘invaded’ normal tissue
What is burn wound sepsis?
Burn Wound Sepsis = invasive burn wound infection + associated systemic sepsis
How do we make the diagnosis of burn wound infection? Ans. : Burn wound biopsy – this is a bedside procedure.
• Scapel excision of elliptical specimen
• If anesthesia is used, inject at the periphery of the biopsy site so the sample is not distorted
• ½ to the micro lab for culture and organism sensitivity
• ½ to the path lab for microscopic evaluation
Histological Staging of the Burn Wound Biopsy Specimen
• Stage 1 COLONIZATION 1a: Superficial, microbes on the surface 1b: Penetrating, microbes into the eschar 1c: Proliferating, microbes in the subeschar space
• Stage 2 INVASION 2a: Microinvasion, microbes in the viable tissue 2b: Deep invasion, microbes into viable subcutaneous tissue 2c: Microvascular invasion, microbes into the blood vessels or lymphatics
Know how to treat burn wound infection
• Apply a penetrating agent if not already in use (Sulfamylon)
• Systemic antibiotics to cover possible organisms until sensitivities are back
• Subeschar injection with broad spectrum penicillin drug using a long spinal needle
• Excision within the next 12 hours with repeat subeschar injection immediately before excision
• WLE of skin and subcutaneous tissue, superficial to the fascia
• WLE may include fascia and muscle
• Consider biopsy of the bed
Fungal
• COLONIZATION ‘not invasion’ most common is candida confined to the surface or eschar usually
• INVASION most common is asperqillus (more aggressive than candida), less common is phycomycetes, the most aggressive true fungi (this organism crosses fascial planes) Treatment of burn fungal wound infection
CANDIDA
Colonization – 2x/day topical (clotrimazole)
Invasion – Immediate excision, 2x/day topical, systemic (Amphotericin B)
ASPERGILLOSIS/PHYCOMYCETES
Invasion – Immediate excision, 2x/day topical, systemic (Amphotericin B)
Viral
• Rare
• MC virus = Herpes Simplex
• Oral, Nasolabial
• Dx: biopsy or scraping
• Tx: topical acyclovir applied q3hrs x 7days
* If hypotension or signs of sepsis suspect systemic herpes. The treatment is systemic acyclovir.
Other infections, Cellulitis
Evident as erythema (redness) around donor sites or burns. Treat with vancomycin or dicloxacillin.
If your patient has a fever and you can’t find a source, consider the following:
Most common sites of infection in a burn patients
Pneumonia
• Cause: airborne
• When: 1.5 – 2 weeks
• Dx: +Chest X-ray with infiltrate plus clinical signs. This should prompt: 1. Gram stain and culture of endobronchial secretions and 2. Antibiotics to cover probable organisms pending culture and sensitivity results.
Suppurative Thrombophlebitis
• Any cannulated or previously cannulated vein
• Limiting intravenous lines to 3 days reduces incidence of infection
• Suspect when hematogenous pneumonia or septicemia without a source
• Dx: Clinical, U/S
• Tx: Exploration, excision, systemic antibiotics for probable organism
Endocarditis
• 1% incidence in burn patients
• Risk – long term infusing catheters
• Suspect when positive blood cultures and no source
• Dx: Echo
• Anatomy: Right-side more common
• Organism: Most common = staph aureus
• Tx: Max dose antibiotic (systemic) three weeks, check for negative blood cultures
Suppurative Sinusitis
• 1% incidence in burn patients
• Risk – long term transnasal intubation, suspect suppurative sinusitis in patients with fever without a source
• Dx: CT scan
• Tx: Broad spectrum antibiotics – surgical drainage may be necessary if unresponsive – consider tracheostomy, gastrostomy
Bacteremia
• 1/5 of blood cultures are positive when obtained during wound manipulation
• Antibiotics covering GP and GN are given during debridement or excision
• Blood cultures are obtained on a scheduled basis
• Positive blood cultures are treated
Urinary Tract Infection
• Especially in patients who have had catheters in place for a prolonged period
Empiric treatment of infections is guided by the unit’s epidemiology.